Help! Questions with my ENT

I am waiting for his response but my ENT responded to my questions about taking the styloid process all the way back to avoid issues later with the fact he thinks it is the ligaments that are calcified that are causing my problems not the process. So was not clear on whether he will take them back at all. Only specifically said he would release the Ligaments. I feel my styloid processes are pretty short but are causing problem because of angle. Compression and even vascular ES symptoms, like dizziness and eye pain and monster headaches. I’m 36 and no other doctor in AR knows anything about this but I feel if he responds he will not be taking my process down I don’t want to do it because I will more than likely need revision surgeries. I need any advice on this. I will update once he replies.

Our chat online:

Most important Q

  1. Will he be taking the styloid process back to the skull and smoothing down to avoid regrowth and continued issues?
    I have heard it is a common mistake when getting this surgery done which leads to revision surgery. I also hear some surgeons will leave the shaved pieces in the patient’s head which leads to issues. It will be completely removed?
    With Eagle’s Syndrome, it is not usually the styloid process that is the problem.–it is the ligament which becomes calcified (bone) that creates the pain and problems. I remove the calcified ligament and release the ligament. It should not grow back.

  2. Does he use robotics for surgery? No–it cannot be used for this small opening.

  3. What is given for swelling? Pain meds and antibiotics and steroids.

  4. I have gastritis and have a lot of trouble taking pain meds. What can we do to combat that? I was thinking of starting an omeprazole cycle before surgery or maybe he has a better plan of action!?
    Take omeprazole before and for about 2 weeks after surgery. Also we can give you anti-nausea pills.

I think there is over 75% chance the calcified stylohyoid ligament is causing your symptoms. The left side is about the same as the right even though you are not having much problems on that side. At your age I would recommend doing both sides because the left side will probably give you problems later and hardly anyone else in the state will operate on this because it is not easy and can have complications. I will probably retire within 2 years.

Hi Dannib,

Thanks for sharing the doctors conversation with you.

In truth, ES is a which came first, the chicken or the egg, scenario in that it isn’t clear whether the styloid process itself elongates or whether it elongates because the stylohyoid ligament attached to it calcifies giving the appearance that the styloid has elongated. When I first saw a knowledgeable ENT, he told me I might have Eagle Syndrome, & when I asked what that is, he said, “It’s calcification of your stylohyoid ligament(s)”. I was, of course, in the dark as to what he was talking about so he showed me on a chart he had in the exam room.

It really doesn’t matter which way you believe, the bottom line is, there is calcification & rigidity in an area where there should be a soft, mobile ligament & where there are a number of nerves, vascular & other soft tissues. The calcification tethers the hyoid bone so it can’t move as it needs to & also causes disruption to the nerves & sometimes blood flow into/out of the area. It sounds like it’s that calcification he intends to remove. Before surgery you can discuss your concerns about vascular compression, but it may well be the section he plans to take out is what’s causing that. We do have a number of surgeons on our list who leave a bit of styloid behind to protect the facial nerve, in particular, as it exits the skull very close to the styloid attachment. The doctors who use the DaVinci robot for this surgery are few & far between, & it is used for intraoral surgery only.

Bilateral surgery does take longer to recover from than having each side done separately, but he does make a good case for doing both at once with his retirement looming in the not so distant future. We have a growing number of members who’ve had successful bilateral surgeries. It’s good from the standpoint that you don’t need to go through recovery twice.

Lastly, it sounds like he has a good plan for managing your gastritis & post op pain & swelling. With bilateral surgery all at once, you’ll likely need to be in the hospital overnight for monitoring. That’s worth asking about as well.

I hope that the info I’ve given is helpful & encouraging. It really sounds like he knows what he’s talking about & has a good plan for you. :kissing_heart: :hugs:


Wow yes! Thank you for the time you took to explain that. I have PTSD from too many bad surgeries (hernias) and now I don’t trust doctors in general. He has done many ES surgeries and I wanted so bad for this to work so I can start on my track to recovery. I am a SAHM with my 4 yo and really have been struggling to function due to pain and lack of sleep. I also found some web pages that back up this info you gave and am feeling like I can relax a bit and go through with this surgery. It’s still so scary but I truly feel he knows what he’s doing but that threw me off track when I was understanding he plans to not shorten the SP. I still am waiting to hear back. I will still share what he says. This forum makes me feel less crazy! Thanks! :smiling_face_with_three_hearts:

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So glad it helped, Dannib! Recovery will be a bit of a challenge with a 4 year old. I hope you have someone to help you for at least the first week, & first two weeks would be even better. I was also a SAHM so I know how demanding that is. I only had two kiddos. Don’t know how moms with larger families do it!!

I’ve also had hernia surgery, but it was minor. It was years after my pregnancies, but I had big-ish babies, & it was an umbilical hernia so I blamed it on pregnancy. :stuck_out_tongue_winking_eye: still took me a month to recover from it. SHEESH!!

He does sound confident that he knows what he’s dong; not everyone has issues with their styloid processes, it can be that the ligaments are just calcified, & the processes are normal…unfortunately the only way to tell really is to go for the op & see- but that is true for all ES surgeries, no reputable surgeon will guarantee that surgery will cure all.
I hope that you feel confident with him :smiling_face_with_three_hearts:


Thank you! I feel a bit more confident now.